This proven and uplifting therapy Source gives you a hierarchy of treatment from fluency enhancement strategies (voicing, breath control, smooth onsets) to cognitive strategies (mental imagery, affirmation, self-talk). The cluttering portion gives you over 30 characteristics of cluttering with nearly as many strategies for treatment.

Outcomes

Develop confidence and competence in your treatment of fluency disorders

Clients become more fluent as they evaluate and change their attitudes and beliefs and learn to use fluency enhancing strategies, self-monitoring techniques, and cognitive/self-instructional strategies

The Source for Stuttering and Cluttering is based on three decades of working with over a thousand fluency-disordered individuals. The unique approach allows clients to reflect on feelings and attitudes related to communication while working on the steps to fluent speech. The book describes very specific, step-by-step procedures for teaching clients to integrate speech-motor skills with the cognitive strategies underlying fluency. The stuttering program has two phases:

Phase I—Orientation and Motor-Speech Practice PhaseVery discreet oral-motor response patterns are taught, one at a time. Clients read, re-read, and practice the material while concentrating.

Phase II—Cognitive and Self-Instructional StrategiesThis section covers the attitudinal and cognitive strategies necessary for durable, lasting improvement. Not only must clients hear themselves getting better verbally, they must "see themselves" more fluent in the future through imagery. Easy-to-follow, guided relaxation; affirmation training; and self-talk strategies are included.

The last section of the book provides a comprehensive account of cluttering. Learn the obligatory symptoms of cluttering, how to assess it, and how to devise a successful treatment program.

An audio CD included with the program contains:

examples of voicing practice and relaxation practice

examples of common client errors

cluttering voice samples

checklist for possible cluttering

Customers tell us that procedures in The Source for Stuttering and Cluttering yield better results than any other methods they have used before. Help your clients master these lessons and share in the joy of gaining control of their fluency and, ultimately, their lives.

I have been working in public schools for the past twenty-seven years. Each year I have about 4-5 students who stutter and 3 or 4 students who clutter. I have several books on stuttering but have not come across any program on cluttering. I was thrilled to find The Source for Stuttering and Cluttering. Mr. Daly explains cluttering and its treatment in a manner easy to understand and do. I share it with parents. After reading the portion on cluttering, one parent made the comment, "So that's what it is!" Learning that cluttering is language-based, with weaknesses in organization and memory, these parents were able to connect their child's cluttered speech with their cluttered bedrooms and unorganized school binders. It made sense to them and to me.

Margie Bodner, SLP Burke, VA

I currently work in Istanbul, Turkey. I ordered The Source for Stuttering and Cluttering and found it really helpful. I would like to thank you for this valuable source. After I read your book and used the techniques presented in it, the improvement was amazing. Thank you for teaching me how to be more helpful to my clients.

Cigdem Buzul, SLP Istanbul, Turkey

Stuttering varies widely across individuals and is typically a multi-faceted disorder (ASHA, 1995).

Cluttering is a disorder with deficits in fluency, rate, and coexisting problems in language and/or articulation (ASHA, 1999).

Therapy should encompass the environmental factors that influence the individual's fluency as well as address the cognitive, affective, and behavioral aspects (Taylor-Goh, 2005).

Using a combination of empirical knowledge, theory, and common practice, appropriate goals should be selected, as well as processes and techniques to achieve those goals, based on a careful evaluation of the client (ASHA, 1995).

It is important to periodically re-evaluate the selection of goals, processes, and techniques with regard to the outcome of treatment (ASHA, 1995).

Research studies support the use of prolonged-speech procedures with adults who stutter. These procedures were used within a comprehensive treatment framework, including initial intensive work, practice in front of groups, specific tasks for transferring fluency, self-management, and an active maintenance program (Bothe, Davidow, Bramlett, & Ingham, 2006).

Literature suggests that treatments successful with adults may also be successful with adolescents (Bothe, Davidow, Bramlett, & Ingham, 2006).

The Source for Stuttering and Cluttering incorporates these principles and is also based on expert professional practice.

Students take an active role in their therapy and develop fluent speech through motor, linguistic, and psychosocial changes. This comprehensive program spells out a clear therapy program and shows you how to tailor treatment to individual student needs.

Author(s)

David A. Daly

Biography

David A. Daly, Ed. D., CCC, is associate professor of Speech-Language Pathology and Special Education at the University of Michigan, where he has served as director of the academic program, speech clinic, and director of Shady Trails residential camp for stutterers.

Currently, David publishes extensively in professional journals, lectures nationwide, and owns and operates a successful private practice in Livonia, Michigan, specializing in chronic stuttering and cluttering. In his 30-plus years of experience in public school, clinic, and private practice settings, David has helped hundreds of stutterers become independent, confident, and successful speakers.

In addition to his many professional interests, David also enjoys sailing and tennis. He is an inspiring and charismatic person who leaves his mark on those he meets with his unique sense of humor and zest for life's inevitable twists and turns.

The Source for Stuttering and Cluttering is a completely revised version of David's first publication with LinguiSystems, The Freedom of Fluency.

Introduction

In this book, I have tried to accomplish two objectives. First, to update you with new information, ideas, and strategies about the treatment of stuttering in children and adults. I have been gratified by the comments and letters from colleagues across the United States, Canada, and Europe on their positive experiences using the Freedom of Fluency program which was published with LinguiSystems in 1988. This reinforcement motivated me to try even harder in this book to identify and clearly describe additional procedures, clinical rationales, and subtle changes which I have found to be most promising with disfluent clients. As a result, The Source for Stuttering and Cluttering contains much new information and specific speech exercises designed to make fluency progress even easier for both client and clinician.

However, colleagues and clinical researchers who have used The Freedom of Fluency encouraged me to not change too much in this revision. They argued that procedures in The Freedom of Fluency were yielding better results than methods they had used before. I was also particularly sensitive that the revision did not "throw out the baby with the bath water." Because of these cautions, I believe that the essential ingredients for successful treatment of chronic fluency disorders have been retained in The Source for Stuttering and Cluttering.

The intent of this book is to offer more ideas, explanations, and strategies to help an even larger number of clinicians become confident and competent when working with fluency disorders. New information on the importance of the clinician's and client's belief systems, the need for clinicians to appreciate and learn the benefit of oral-motor exercise in therapy, and the significance of practice outside of therapy are emphasized. Central to these factors is the importance of helping both clients and clinicians to take action; that is, to decide on a plan of treatment, to teach specific strategies thoughtfully one task at a time, and then to assist the client in taking action. The necessity of over-practicing the various target fluency responses can't be overemphasized.

Beyond updating the information on stuttering in The Freedom of Fluency, The Source for Stuttering and Cluttering was written to objectively identify, describe, and differentiate from typical stutterers a separate group of clients known as clutterers. A section of this book provides you with as current and comprehensive an account of cluttering as possible. Clinicians who have been puzzled with some slow-changing, atypical stuttering clients, many of whom also may show poor awareness, significant language disturbances, poor oral-motor abilities, rapid or fluctuating rates of speech, and difficulty with topic maintenance should find this section quite illuminating.

In addition to my own clinical experiences with people who present with cluttering disorders, I have gathered what information I could on the topic from conferences, recent literature, and from the personal experiences of others. These in-depth discussions with colleagues about their clinical and research experiences, suspicions, clinical hunches, and hypotheses about this "orphan" in the field of speech-language pathology have been most stimulating and informative. Cluttering has been a specific clinical interest of mine for more than 2 decades and my hope is that readers who also witness this kind of disfluent individual will find the discussion and suggested clinical strategies in The Source for Stuttering and Cluttering particularly valuable.